腹腔镜APR行生物补片盆底腹膜重建的临床研究

Clinical study of the pelvic peritoneum reconstruction with biological mesh in laparoscopic APR

目的研究腹腔镜经腹部-会阴联合直肠癌根治术(abdomino perineal resection,APR)行生物补片盆底腹膜重建的临床意义。方法回顾性分析2017年4月至2020年6月山东大学附属济南市中心医院胃肠外一科收治的69例低位直肠癌患者,行腹腔镜APR,其中41例行生物补片盆底腹膜重建(重建组)、28例未行重建(未重建组)。观察手术时间、住院时间、肠梗阻发生率、切口感染发生率及放射性肠炎(radiation enteritis,RE)发生率等指标。结果重建组的肠梗阻发生率(2.4%比21.4%)、切口感染发生率(9.8%比32.1%)、RE(2.4%比28.6%)发生率优于未重建组(P<0.05);而手术时间、住院时间等差异无统计学意义(P>0.05)。结论腹腔镜APR行生物补片盆底腹膜重建是安全、有效的。

Objective To evaluate the clinical value of the pelvic peritoneum reconstruction with biological mesh after laparoscopic abdominoperineal resection(APR).Methods Retrospected the 69 low rectal cancer patients from Apr.2017 to Jun.2020 in Jinan Central Hospital Affiliated to Shandong University.All the patients had underwent the laparoscopic APR.41 patients used the biological mesh to reconstruct the pelvic peritoneum.28 patients didn′t reconstruct the pelvic peritoneum.The operation time,postoperative hospital stay,perineal wound infection,incidence of radioactive enteritis and incidence of intestinal obstruction were compared.Results The reconstruction of pelvic peritoneal by biological mesh in laparoscopic APR significantly reduced the incidence of intestinal obstruction(2.4%21.4%),perineal wound infection(9.8%32.1%)and radiational enteritis(2.4%28.6%)after surgery(P<0.05).There was no significant difference in operation time,postoperative hospital stay time(P>0.05).Conclusions Pelvic peritoneum reconstruction with biological mesh is safe and effective for patients who underwent laparoscopic APR.